NPIMap

Organization Active NPI

Mercy Memorial Hospital Corporation

  • Emergency Medicine Physician
  • Dundee, MI
National Provider Identifier
1174700694
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MERCY MEMORIAL HOSPITAL CORPORATION
Practice address
100 Powell Dr
Dundee, MI 48131-8644
Phone
(734) 240-1440
Fax
(734) 240-1550
NPI assigned
Jan 28, 2008
Last updated
Jan 28, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
URGENT CARE PHYSICIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen Grider, DO
Title
Group Rep
Phone
(734) 240-1440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

100 Powell Dr
Dundee, MI 48131-8644

Mailing address

100 Powell Dr
Dundee, MI 48131-8644
Phone (734) 240-1440

Other identifiers 1

IdentifierTypeStateIssuer
0E81101OtherMIBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
Mercy Memorial Hosp10 organizations share this tax ID, including this one
Part of
Mercy Memorial Hosp

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1174700694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POWELL DR",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481318644",
            "telephone_number": "734-240-1440",
            "fax_number": "734-240-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POWELL DR",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481318644",
            "telephone_number": "734-240-1440",
            "fax_number": "734-240-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "URGENT CARE PHYSICIANS",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "GRIDER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "GROUP REP",
        "authorized_official_telephone_number": "734-240-1440",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0E81101",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.